VT-Ablation als Alternative zum Defibrillator: Wer ist ein Kandidat?

Zusammenfassung

Patienten mit struktureller Herzerkrankung sind besonders gefährdet, eine ventrikuläre Tachykardie (VT) zu erleiden, das Risiko für den plötzlichen Herztod (PHT) ist erhöht. Implantierbare Kardioverter-Defibrillatoren (ICD) sind zur Prävention des PHT seit mehr als 20 Jahren in der Primär- und Sekundärprophylaxe empfohlen, wobei in der Sekundärprophylaxe die linksventrikuläre Ejektionsfraktion (LVEF) keine Rolle spielt. Ein Patient mit einer LVEF von > 35% und hämodynamisch tolerierter VT scheint ein Kandidat zu sein, der von einer primären Strategie der Katheterablation (KA) profitiert, ohne dass sofort ein ICD als „Reserve“ benötigt wird.

Abstract

Patients with structural heart disease are at risk of experiencing ventricular tachycardia (VT), and the risk of sudden cardiac death (SCD) is increased. Implantable cardioverter defibrillators (ICD) have been recommended for primary and secondary prevention of SCD for more than 20 years, and left ventricular ejection fraction (LVEF) plays no role in secondary prevention. A patient with an LVEF of > 35% and hemodynamically tolerated ventricular tachycardia (VT) appears to be a candidate who may benefit from a primary catheter ablation (CA) strategy without the immediate need for an ICD as a “backup.”

Schlüsselwörter

Alternative - VT-Ablation - ICD-Implantation

Keywords

alternative - VT ablation - ICD implantation

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